Akut Lösemili Hastalarda Febril Nötropeni Ataklarının Klinik Ve Mikrobiyolojik Özellikleri

Authors : H ÇELEBİ, M TURGUT, İ YÜCEL

Pages : 0-0

Doi:10.5835/jecm.v20i4.127

View : 31 | Download : 18

Publication Date : 2009-12-23

Article Type : Other Papers

Abstract :Akut lösemili hastalarda infeksiyon en büyük morbidite ve mortalite nedenidir. Biz akut lösemili hastalarda febril nötropeni ataklarını retrospektif olarak inceledik. Çalışmaya 50 hasta alındı. Median nötropeni süresi 15 gündü. Febril nötropenik atakların 27`sinde insert ignore into journalissuearticles values(%54); bakteriyemi gösterildi. Bakteriyemi nedeni olarak Gram-negatifler 15 insert ignore into journalissuearticles values(%56);, Gram-pozitifler ise 12 insert ignore into journalissuearticles values(%44);`ü oluşturuyordu. En sık görülen patojenler E. coli insert ignore into journalissuearticles values(8);, Coagulase negative staphylococci insert ignore into journalissuearticles values(7);, Enterecoccia insert ignore into journalissuearticles values(6); Staphylococcus aereus insert ignore into journalissuearticles values(6); ve Candida insert ignore into journalissuearticles values(3); idi. Febril nötropeni ataklarının 11`inde insert ignore into journalissuearticles values(%22); klinik olarak infeksiyon nedeni saptandı. Bütün hastalara ampirik antibiyotik tedavisi başlandı. Betalaktam + aminoglikozid kombinasyonu 15 atakta kullanıldı. Geniş spekturumlu antibiyotik tedavisine ragmen ateşi devam eden hastalara antifungal tedavi olarak amphoterisin insert ignore into journalissuearticles values(18); veya flukonozol insert ignore into journalissuearticles values(6); eklendi. Bu çalışmada infeksiyon komplikasyonuna baglı altı hasta insert ignore into journalissuearticles values(%12); öldü. Bizim sonuçlarımız Gram-negatif infeksiyonların hala çogunlukta oldugunu ve Gram-pozitif infeksiyonlar ile pnömonide yüksek mortaliteye egilim olduğunu göstermiştir Clinical and Microbial Features of The Episodes of Febrile Neutropenia in Acute Leukemia Patients Infections are the major causes of morbidity and mortality in acute leukemia patients. We retrospectively analyzed the episode of febrile neurtopenia in acute leukemia patients. This study included 50 patients. Median neutropenia duration was 15 day. Bacteremia was confirmed in 27 episodes insert ignore into journalissuearticles values(54%); of which 15 insert ignore into journalissuearticles values(56%); were caused by Gram-negative bacilli and 12 insert ignore into journalissuearticles values(44%); by Gram-positive cocci. The predominant organisms were: E.coli insert ignore into journalissuearticles values(8);, Coagulase negative staphylococci insert ignore into journalissuearticles values(7);, Enterecoccia insert ignore into journalissuearticles values(6);, Staphylococcus aereus insert ignore into journalissuearticles values(6);, Candida insert ignore into journalissuearticles values(3);. In eleven episodes insert ignore into journalissuearticles values(22%); clinical infections were diagnosed. All patients were started empirically on antibacterial agents. A combination of betalactums and aminoglycoside were used in 15 episodes. Antifungal therapy with amphotericin B insert ignore into journalissuearticles values(18); or fluconazole insert ignore into journalissuearticles values(6); was added because of persistent fever despite broad antibacterial coverage. Six patients died insert ignore into journalissuearticles values(12%); of infections complications in this study. Our results show that infections with Gram-negative bacteria continue to predominate. A trend toward a higher mortality of infections caused by Gram-positive cocci and pneumonia were noted.
Keywords :

ORIGINAL ARTICLE URL